Contraception and Pregnancy

teenage sex

It's important to be informed about sexual health issues, even if you're not having sex right now, and if you are, then you need to arm yourself with some critical facts! Here you'll find plenty of info on how to protect yourself from getting pregnant, what to do if you think you're pregnant, what to do if you've had unprotected sex (or sex in which your method of birth control failed) in the last 72 hours, and where to go for help.

Birth Control Misinformation

There are a lot of myths and misinformation out there about protecting yourself from pregnancy. If you are considering any of these, forget about it. They DON'T work!

• Having intercourse during your period:
  First of all, just because you're bleeding doesn't mean you're having your "true" period; some women bleed during ovulation. And it's often hard to predict when you'll ovulate. So you'd better use protection whenever you have intercourse, all month long. (Sex during your period is also a riskier time for HIV transmission.)
• Peeing after intercourse:
  An old folks' tale! Urinating after sex does nothing to protect against pregnancy because women do not urinate out of their vaginal opening. So, although the urinary opening is near the vagina (just above it), urinating will not flush sperm out of the vaginal opening.
• Douching:
  Rather than rinsing sperm out of the vagina, douching could actually send them swimming upstream towards an egg. (It can also increase the risk of infection.) All in all, a bad idea!

Birth Control Options

Birth Control Pills

• Concept: A woman takes a pill that contains artificial hormones - either a combination of estrogen and progestin, or a progestin-only pill - every day. The pill works by preventing ovulation, increasing cervical mucus to block sperm, and creating a thin, unfriendly uterine environment.

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• Success Rate: With typical use, five women in 100 become pregnant in one year. With perfect use, less than one woman in 100 will become pregnant in one year.
• Positives: If taken consistently and correctly, the pill provides non-stop protection from pregnancy, can make a woman's periods more regular, reduce cramps, and shorten or lighten a woman's period.
• Negatives: Offers no protection against STDs including HIV; can cause side effects such as nausea, headaches and moodiness. Also, you need to remember to take the pill every day, and if you miss two or more pills in a cycle, or you are late starting a new cycle of pills, you should strongly consider using a back-up contraceptive until you have taken seven consecutive pills.
• Where to Get It: Through a prescription from a health care provider; the cost runs $15 to $40 a month depending on the pill brand, plus the cost of the visit to your health care provider. (Many clinics also have sliding scale fees, meaning you pay based on what you can afford.)

Cervical Cap

• Concept: A woman uses spermicide to coat the inside of this silicone or latex thimble-shaped device. Then she inserts it to the back of her vagina so that it suctions over the cervix, where it blocks sperm.
• Success Rate: With typical use, 20 women out of 100 become pregnant in one year. With perfect use, nine women out of 100 become pregnant in one year.
• Positives: It can provide continuous protection for 48 hours, no matter how many times you have intercourse (unlike the diaphragm, additional spermicide is not needed for additional acts of intercourse).
• Negatives: Won't protect effectively against most STDs, including HIV; can increase the risk of urinary tract infections and toxic shock syndrome; it only comes in four sizes so it may not be an option for everyone. Also, it has to stay in place for six hours after the last act of intercourse.
• Where to Get It: Through a prescription from a health care provider; the cost is about $35 to $60 plus the cost of spermicide, and the exam and fitting for the cervical cap. Many clinics also have sliding scale fees, meaning you pay based on what you can afford.

Condom - Female

• Concept: A thin polyurethane sheath, shaped like a small pouch with flexible rings at each end. The ring at the closed end holds the pouch in place inside the vagina, while the ring at the open end remains outside the vagina. The pouch collects semen and prevents it from entering the vagina.
• Success Rate: With typical use, 21 out of 100 women will become pregnant. With perfect use, five out of 100 will become pregnant.
• Positives: Protects against STDs, including HIV, and you can get it without a prescription. Also, you can insert it up to eight hours before having intercourse. If you are allergic to latex, this polyurethane condom is a good alternative.
• Negatives: The outside ring can slide inside the vagina during intercourse; also, caution should be used to make sure the man's penis doesn't slip around the side of the condom. Can be awkward to use at first; must be removed right after intercourse, before you stand up, to prevent semen leakage.
• Where to Get It: Buy it at drugstores or supermarkets or get it from family planning clinics; the cost, $2-$4 each.

Condom - Male

• Concept: A polyurethane or latex sheath (rubber) covers the penis and collects the semen, preventing sperm from entering a woman's vagina. There are animal skin condoms available; however, unlike latex or polyurethane condoms, they do not provide protection from STDs, including HIV.
• Success Rate: With typical use, 14 women in 100 will become pregnant in one year. With perfect use, three women in 100 will become pregnant in one year.
• Positives: It provides good protection against most STDs, including HIV, the virus that causes AIDS. Plus, it's cheap, easy to carry around, and can be bought at any drugstore without a prescription.
• Negatives: It can break especially if it's not put on correctly; likewise, it can leak if not withdrawn carefully. Latex condoms must not be used with any oil-based lubricants like vaseline or massage oil. And some people may experience allergies to latex condoms.
• Where to Get It: At drugstores and supermarkets; costs anywhere from 50 cents and up to several dollars a piece depending on the brand and style. They are often free at family planning clinics.

Depo-Provera

• Concept: A woman gets an intramuscular shot of the artificial hormone progestin every three months, which keeps her from getting pregnant.
• Success Rate: Less than one woman in 100 will become pregnant in a year using this method.
• Positives: Once you get the shot, you don't have to think about birth control for three months.
• Negatives: Offers no protection against STDs, including HIV; also, may cause weight gain, irregular periods, and depression.
• Where to Get It: Requires a visit to your health care provider every three months for administration of the shot; the cost is about $35-$60 per shot, plus the cost of the office visit. Many clinics also have sliding scale fees, meaning you pay based on what you can afford.

Diaphragm

• Concept: A woman uses spermicide to coat this dome-shaped silicone or latex cup with a flexible rim. Then she inserts it to the back of her vagina so that it covers the cervix, where it blocks sperm.

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• Success Rate: With typical use, 20 women out of 100 become pregnant in one year. With perfect use, six women out of 100 become pregnant in one year.
• Positives: It can be put in place up to six hours before intercourse and can stay there for 24 (though fresh spermicide should be applied each time you have intercourse).
• Negatives: Won't protect effectively against most STDs, including HIV; can increase the risk of urinary tract infections and toxic shock syndrome; Can be messy (thanks to the spermicide) and clumsy to use until you get the hang of it. Also, it has to stay in place for six hours after the last act of intercourse and then needs to be washed thoroughly with soap and water.
• Where to Get It: Through a prescription from a health care provider; the cost is about $30 to $40 plus the cost of spermicide, and the exam and fitting for the diaphragm. Many clinics also have sliding scale fees, meaning you pay based on what you can afford.

IUD

• Concept: A small device that contains copper or a synthetic progestin hormone is inserted into a woman's uterus.
• Success Rate: Using a copper IUD, less than one woman in 100 will become pregnant in a year; using a progesterone IUD, two women in 100 will become pregnant.
• Positives: It provides very effective pregnancy protection and lasts a long time - a copper IUD can stay in place for up to ten years, a progesterone IUD lasts one year.
• Negatives: Doesn't protect against STDs, including HIV. With a copper IUD, spotting may occur between periods, periods may be heavier, and menstrual cramps may increase. A progesterone IUD is likely to cause spotting between periods and to reduce cramps and bleeding. If a woman using an IUD is exposed to infectious organisms, she risks having that infection spread upward to cause PID - pelvic inflammatory disease - a catch-all term for infections in the uterus, fallopian tubes, ovaries and/or pelvis. PID, in turn, can cause infertility. The IUD isn't recommended for women who haven't had children yet but want to in the future. Insertion can be painful.
• Where to Get It: From a health care provider; cost is about $150 to $300 for insertion and removal costs about $100. Many clinics also have sliding scale fees, meaning you pay based on what you can afford.

Norplant

• Concept: Six small rods are inserted under the skin of a woman's upper arm, and these rods release the synthetic hormone progestin that prevents pregnancy.
• Success Rate: Less than one woman in 1,000 becomes pregnant in one year.
• Positives: It protects against pregnancy for up to five years -without your having to do a thing. Plus, it starts working within 24 hours of insertion.
• Negatives: Doesn't protect against STDs including HIV; may cause irregular periods, headaches, weight gain, and acne. Some women may be able to see the rods under the skin. Plus, having the rods removed can be a hassle.
• Where to Get It: Requires a visit with a health care provider; the cost for insertion is usually about $500 to $800, while removal usually costs more because it takes more time to do. Many clinics also have sliding scale fees, meaning you pay based on what you can afford.

Rhythm Method

• Concept: You keep track of a woman's menstrual cycle and have intercourse only during the "safe" (or infertile) days.
• Success Rate: Typical use is difficult to estimate with this method, but with perfect use, about nine women out of 100 become pregnant in one year.
• Positives: It's free and there are no devices to deal with. And there are no side effects (except having to go without intercourse for several days before and after ovulation).
• Negatives: Predicting when a woman will ovulate is not easy, and sperm can live inside a woman's body for several days. You have to keep careful track of your vaginal mucus, menstrual cycle, and/or body temperature to accurately track your fertility patterns beginning several months before you start relying on this method. Because of the difficulty of using this method, there are a lot of accidental pregnancies. Also, it doesn't protect against STDs, including HIV.
• Where to Get It: You will need good instruction - a class or clinician who can work with you - and several months of charting before you begin to rely on this method.

Spermicide

• Concept: A woman inserts a spermicide - available in foams, creams, jellies, films, or suppositories - deep into the vagina before sex to kill sperm before it can reach an egg.

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• Success Rate: With typical use, 26 women out of 100 will become pregnant in one year. With perfect use, six women out of 100 will become pregnant in one year.
• Positives: You can buy it at any drugstore - without a prescription; it can provide lubrication for intercourse.
• Negatives: Doesn't reliably protect against STDs, including HIV; plus, the chemicals can cause irritation or allergic reactions. Some spermicides such as nonoxynol-9 have been found to cause so much irritation to the vaginal walls that they can make the user more susceptible to STD and HIV infection. It's messy, and you need to follow directions for your product carefully - this may mean waiting after inserting spermicide before having intercourse, to allow time for it to dissolve and spread. You must insert more spermicide each time you have intercourse.
• Where to Get It: At drugstores or supermarkets. The cost is $9 to $12 for the spermicide and applicator; refills cost $4 to $8.

Tubal Ligation (female sterilization)

• Concept: In a surgical procedure, a woman's fallopian tubes are blocked or cut so that sperm and egg cannot unite.
• Success Rate: Less than one woman in 100 will become pregnant in a year.
• Positives: It's a permanent form of birth control; there are no lasting side effects.
• Negatives: Offers no protection against STDs, including HIV; if the procedure fails, there's an increased chance of tubal (ectopic) pregnancy (a dangerous situation in which a fertilized egg starts to develop in one of the fallopian tubes). Although it may be possible for the surgery to be reversed if a woman decides she wants to have another child, it's complicated, expensive, and doesn't always succeed. That's why the procedure is recommended only for women who have all the children they want, or who are absolutely sure they don't ever want to have children.
• Where to Get It: Talk to your health care provider; the cost is expensive, and depends on where you have the procedure done and how much your insurance will cover.

Vasectomy (male sterilization)

• Concept: It's a surgical procedure for men, in which the tubes that transport sperm into semen are blocked or tied off.
• Success Rate: Less than one woman in 1,000 becomes pregnant in one year.
• Positives: It's a permanent form of birth control; there are no lasting side effects; it's safe, quickly performed, and cost-effective over the long run.
• Negatives: Doesn't protect against STDs, including HIV. Although reversal of the procedure is possible, it's expensive and not always successful. That's why the procedure is recommended only for men who have all the children they want, and are absolutely sure they do not want children in the future. After vasectomy it takes about 6 weeks for all sperm to be cleared, so another method of birth control must be used until a follow-up check shows no sperm in the man's semen.
• Where to Get It: Talk to your health care provider; cost can be fairly expensive depending on where you have the procedure done and how much your insurance will cover.

Withdrawal (coitus interruptus)

• Concept: The man withdraws his penis from the vagina before ejaculation.
• Success Rate: With typical use, nineteen women out of 100 become pregnant in one year. With perfect use, four women out of 100 become pregnant in one year.
• Positives: It's better than not using any protection, but it isn't a very effective method of birth control.
• Negatives: Because live sperm can live in pre-ejaculate, even if a man withdraws right some semen can escape prior to ejaculation, so you have a good chance of getting pregnant. It does not protect against STDs, including HIV. Also, it may be a stressful method to rely on because women have to rely on a man to get it right, and men have to concentrate on pulling out so they may not be able to enjoy the moment.
• Where to Get It: Just do it.

Emergency Contraception

Had intercourse without birth control (or a condom break) in the past three days? Call your health care provider or a clinic to ask about your emergency contraception options, or call the Emergency Contraception Hotline at 1-888-NOT2LATE to find a clinic near you.

Afraid you might be pregnant? See your health care provider for a pregnancy test as soon as you can, or get a pregnancy test at the drugstore. If you use a home test, make sure you follow the package directions. You may not be able to get an accurate test result soon after having unprotected sex. If the test is negative, take another one again in a week. If it's positive, definitely see your health care provider right away. An exam to confirm pregnancy early can help avoid possible problems later on. To find a health care provider near you where you can get confidential testing and information, call the Planned Parenthood Hotline at 1-800-230-PLAN.

next: What Teens Want Other Teens To Know About Preventing Teen Pregnancy